Warkentin B
Z Geburtshilfe Perinatol. 1976 Jun;180(3):230-3.
The actual mechanism of tocolytic effect of beta-mimetics is not yet known. While they are able to stop labour, the effect in vitro on myometral filaments is very different. In contrast to this, the socalled Ca++ -antagonists have an excellent relaxing effect on myometrium in vitro, but they are clinically ineffective. To clear up the mechanism of tocolysis, the uterine activity under tocolytic therapy was observed by external tocography. Whereas in normal pregnancy the portion of Braxton-Hicks-contractions and phases of inactivity--equivalent to the intervals of labour -- increases and the portion of Alvarez waves decreases, under tocolysis these changes are not to be found for a long time. The portion of Braxton-Hicks-contractions and phases of inactivity together is smaller than in normal pregnancy. The proportion of Braxton-Hicks-contractions to phases of inactivity corresponds well to normal pregnancy. The changes of uterine activity in normal pregnancy are explained as a process of increasing coordination. The tocolytic effect is regarded as a disturbance of this process.
β-拟交感神经药的实际宫缩抑制作用机制尚不清楚。虽然它们能够抑制分娩,但对子宫肌丝的体外作用却大不相同。与此相反,所谓的钙拮抗剂在体外对子宫肌层有极佳的松弛作用,但在临床上却无效。为了弄清宫缩抑制的机制,通过外部宫缩图观察了宫缩抑制治疗下的子宫活动。在正常妊娠中,Braxton-Hicks宫缩的比例以及相当于分娩间隔的静止期会增加,而阿尔瓦雷斯波的比例会降低,在宫缩抑制治疗下,这些变化在很长一段时间内都不会出现。Braxton-Hicks宫缩和静止期的比例之和小于正常妊娠。Braxton-Hicks宫缩与静止期的比例与正常妊娠相当。正常妊娠中子宫活动的变化被解释为协调增加的过程。宫缩抑制作用被认为是对这一过程的干扰。